NPIMap

Organization Active NPI

Crowley'S Ridge Development Council, Inc.

  • Multi-Specialty Clinic/Center
  • Jonesboro, AR
National Provider Identifier
1275299786
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CROWLEY'S RIDGE DEVELOPMENT COUNCIL, INC.
Doing business as
Northeast Arkansas Regional Recovery Center
Practice address
6009 C W Post Rd Ste 102
Jonesboro, AR 72401-8139
Phone
(870) 932-0228
Fax
(870) 910-5689
NPI assigned
Nov 10, 2021
Organization subpart
Yes
Parent organization
CROWLEYS RIDGE DEVELOPMENT COUNCIL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeremy Wooldridge, LCSWNPI 1922275213
Title
Ceo
Phone
(870) 932-0228

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X
Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X
Case Management Agency 251B00000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

6009 C W Post Rd Ste 102
Jonesboro, AR 72401-8139

Mailing address

6009 C W Post Rd Ste 102
Jonesboro, AR 72401-8139
Phone (870) 932-0228

Other names 1

  • Northeast Arkansas Regional Recovery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Crowley'S Ridge Development3 organizations share this tax ID, including this one
Part of
Crowley'S Ridge Development

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6009 C W Post Rd
Ste 102
Jonesboro, AR 72401
Phone (870) 932-0228

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1275299786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6009 C W POST RD STE 102",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724018139",
            "telephone_number": "870-932-0228",
            "fax_number": "870-910-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6009 C W POST RD STE 102",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724018139",
            "telephone_number": "870-932-0228",
            "fax_number": "870-910-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWLEY'S RIDGE DEVELOPMENT COUNCIL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CROWLEYS RIDGE DEVELOPMENT COUNCIL, INC",
        "enumeration_date": "2021-11-10",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "WOOLDRIDGE",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-932-0228",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Arkansas Regional Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.